Sylacauga Pharmacy, LLC

Details

Name:	Sylacauga Pharmacy, LLC
Jurisdiction:	Alabama
Legal type:	Domestic Limited Liability Company
Status:	Exists
Date of registration:	25 Jul 2018 (6 years ago)
Entity Number:	000-525-426
Register Number:	000525426
County:	Shelby
Place of Formation:	Shelby County
Registered Office Street Address:	1020 BERRINGTON CIRCLEBIRMINGHAM, AL 35242
Registered Office Street Address ZIP Code:	35242

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1902377716

2018-12-06

2019-08-16

PO BOX 381134, BIRMINGHAM, AL, 352381134, US

1244 TALLADEGA HWY, SYLACAUGA, AL, 351501603, US

Contacts

Phone

+1 256-208-9595

Authorized person

Name	HANG M DINH
Role	PRINCIPAL
Phone	2562089595

Taxonomy

Taxonomy Code	333600000X - Pharmacy
Is Primary	Yes

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

SYLACAUGA PHARMACY (WELFARE PLAN)

2022

831440024

2023-07-27

SYLACAUGA PHARMACY

1

File	View Page
Three-digit plan number (PN)	951
Effective date of plan	2020-10-01
Business code	446110
Sponsor’s telephone number	8669665457
Plan sponsor’s address	PO BOX 381134, BIRMINGHAM, AL, 36238

Plan administrator’s name and address

Administrator’s EIN	472506773
Plan administrator’s name	KENNION & CO, LLC
Plan administrator’s address	2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243
Administrator’s telephone number	8669665457

Signature of

Role	Plan administrator
Date	2023-07-19
Name of individual signing	W. HAL SHEPHERD

Role	Employer/plan sponsor
Date	2023-07-19
Name of individual signing	W. HAL SHEPHERD

SYLACAUGA PHARMACY (WELFARE PLAN)

2021

831440024

2022-07-29

SYLACAUGA PHARMACY

1

File	View Page
Three-digit plan number (PN)	951
Effective date of plan	2020-10-01
Business code	446110
Sponsor’s telephone number	8669665457
Plan sponsor’s address	PO BOX 381134, BIRMINGHAM, AL, 36238

Plan administrator’s name and address

Administrator’s EIN	472506773
Plan administrator’s name	KENNION & CO, LLC
Plan administrator’s address	2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243
Administrator’s telephone number	8669665457

Signature of

Role	Plan administrator
Date	2022-07-20
Name of individual signing	W. HAL SHEPHERD

Role	Employer/plan sponsor
Date	2022-07-20
Name of individual signing	W. HAL SHEPHERD

SYLACAUGA PHARMACY (WELFARE PLAN)

2020

831440024

2021-07-25

SYLACAUGA PHARMACY

0

File	View Page
Three-digit plan number (PN)	951
Effective date of plan	2020-10-01
Business code	446110
Sponsor’s telephone number	8669665457
Plan sponsor’s address	PO BOX 381134, BIRMINGHAM, AL, 36238

Plan administrator’s name and address

Administrator’s EIN	472506773
Plan administrator’s name	KENNION & CO, LLC
Plan administrator’s address	2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243
Administrator’s telephone number	8669665457

Signature of

Role	Plan administrator
Date	2021-07-23
Name of individual signing	W. HAL SHEPHERD

Role	Employer/plan sponsor
Date	2021-07-23
Name of individual signing	W. HAL SHEPHERD

Organizer

Name	Role	Address
HASTY, WILLIAM D JR	Organizer	2090 COLUMBIANA ROAD STE 2000BIRMINGHAM, AL 35216

Agent

Name	Role
DINH, HANG M	Agent

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State